good work, but incomplete. theres also the risk of being pummeled by numerous assholes who insist theres nothing wrong with your eyes, and there's the risk of confronting an industry that tries to silence damaged patients. i could forgive a surgical mistake or an accident. i can't forgive systematic deception followed by arm twisting in the name of money, and unless im missing something, thats what this site is about.

theres also the risk of being surrounded by patients that are too damn scared to speak out. thats no fun either. and theres the risk of having to put up with nonprofits that refuse to tell the truth about the industry because theyre trying to get help for people and end up misrepresenting bad outcomes to the public as random results rather than systematic lies when what the public really ought to know is the systematic lies.

and theres the risk of finding that you yourself are too afraid to speak out when you know in your heart that you ought to be doing more.

Those are all good suggestions, and I hope that updates of The LASIK Report will convey these truths.

I have one question for you on a personal note.

What more can the industry do to you once your vision is compromised for life? You have nothing left to be afraid of... and you have the first amendment to protect your right to tell your story as long as it is the truth.

It took some time, but I have lost all of my fear.

We should not fear surgeons or the industry - they should fear us! They have damaged us and are committed to share a small planet with their casualties for the rest of their lives.

Far too small a world to run and hide... and no way they can say they 'didn't know'.

What more can the industry do to you once your vision is compromised for life? You have nothing left to be afraid of...

I disagree. Patients have a lot more to lose after losing their eyesight.

Consider what patients must go through to file a medical malpractice lawsuit against a negligent surgeon... defense attorneys with no morals who will stop at nothing to intimidate and harass patients into dropping the lawsuit... so-called "expert" witnesses, slimy lying surgeons, whose testimonies are for sale to the highest bidder, who will say anything to get a lousy, careless surgeon off the hook... the legal system which drags on forever and forever, year after year leaving the patient in limbo trying to go on with life wearing a ball and chain... legal bills stacking up and up, thousands and thousands and thousands of dollars in legal bills... with no guarantee that the surgeon will be held accountable, even in the most black and white cases of malpractice, and even if the patients wins the case, by the time legal bills are paid, the patient is lucky if they walk away with a dime for a lifetime of damaged vision and poor quality of life.

Patients have a lot more to lose than eyesight...

Sometimes they lose their marriages...

Sometimes they lose their jobs...

They may lose their independence...

When 2nd opinion doctors lie to coverup for the operating surgeon, patients lose their faith in doctors...

They lose their joy...

They lose their faith in God...

Sometimes they lose their will to live. This happens far, far more frequently than the LASIK industry will ever admit.

And if you stand up to confront and expose the lies, you become a target of LASIK industry. This is not an easy choice to make. For most patients it's easier to go away quietly and suffer in silence.

_________________Broken Eyes

"The price good men pay for indifference to public affairs is to be ruled by evil men." Plato

nonprofits that refuse to tell the truth about the industry because theyre trying to get help for people and end up misrepresenting bad outcomes to the public as random results rather than systematic lies when what the public really ought to know is the systematic lies.

When 2nd opinion doctors lie to coverup for the operating surgeon, patients lose their faith in doctors...

They lose their joy...

They lose their faith in God...

Sometimes they lose their will to live. This happens far, far more frequently than the LASIK industry will ever admit.

And if you stand up to confront and expose the lies, you become a target of LASIK industry. This is not an easy choice to make. For most patients it's easier to go away quietly and suffer in silence.

I didn't lose my job and have never been married, but aside from that I have lost everything else you've listed. I have a hard time driving places I have never been at night - I'll only use familiar roads close to home, and only if I absolutely must go out at night.

Yep, I've lost everything but the job and I'm ready for anything the LASIK industry throws at me. Bring it on.

Last edited by Eye on Sat Nov 25, 2006 5:21 pm, edited 1 time in total.

It will probably also include evidence that the anterior cornea is stronger than the posterior.

Example:

Quote:

LASIK studies do not report flaps of less than 160 ?m, which means that the flap always includes the most stable part of the cornea and is connected at the temporal side of the cornea by a small hinge. In a histological study in humans in which LASIK was performed before enucleation of one eye it was demonstrated that mainly fibronectin and tenascin were formed at the border between flap and stroma. These adhesive glycoproteins are present between epithelium and Bowman's layer and can easily be disrupted to perform additional laser treatments. There is no need to wonder why various patients suffer from wrinkles within the flap and epithelial ingrowth.

Quote:

PRK is different from LASIK because a great part of the most anterior stroma is ablated. Bowman's layer does not recover and irregularities on the surface are compensated by ingrowth of epithelial cells (personal observation). Interference with the most tightly interwoven part of the cornea may result in visual problems. A significant proportion of treated patients may show refractive regression, haze, or astigmatism after both types of treatment. Astigmatism is a clinical complication related to irregularities in the corneal curvature. Formation of these irregularities may be due to a reduction in cohesiveness of the collagen bundles in the central corneal stroma. Our results indicate that the most rigid part of the stroma is ablated (PRK) or intersected (LASIK), thus weakening the stability of the cornea. This emphasises that people who underwent refractive surgery may have an increased risk of optical problems.

Quote:

The biomechanical strength of the posterior stroma is less than that of the anterior stroma. Because the load-bearing function of the anterior stroma is disabled after keratotomy, only the weaker deep stroma is left to maintain corneal integrity.

Quote:

Increased severing of corneal lamellae Dr Jaycock noted that the likely cause of the increased biomechanical instability following LASIK compared to PRK was the increased number of collagen lamellae that are severed in the intrastromal procedure. Collagen lamellae are more densely interwoven in the superficial third of the stroma than in the deeper two thirds. In addition, X-ray diffraction studies indicate that collagen fibres cross perpendicularly in the centre and cross increasingly obliquely towards the periphery of the cornea. (Meek et al, Exp Eye Res;2004:78;503-512). Thus the cornea is stronger anteriorly than posteriorly and stronger peripherally than centrally. In a 6.0 dioptre PRK correction, approximately five million collagen fibres are severed, whereas for a corresponding LASIK procedure, 230 million fibres are severed, Dr Jaycock pointed out. ?It is somewhat unfortunate that the standard microkeratome flap incision severs the cornea at the strongest part in both the antero-posterior and radial planes. PRK and LASIK clearly have very different postoperative implications for the structural integrity of the cornea,? Dr Jaycock added.

All the studies in the published literature tell us that the anterior one-third of the cornea is exceptionally strong. In this part, the collagen fibres are interwoven and it is very difficult to pull them apart. There is a lot of biomechanical strength there. The deeper two-thirds of the cornea, by contrast, are actually weak.

Quote:

Explaining the implications of this, Dr. Marshall said that when a 6 dioptre PRK or LASEK correction is carried out, around five million supporting collagen fibrils are severed. This increases 40-fold in a LASIK procedure to over 230 million collagen fibrils. He added that lowering the flap in a LASIK procedure will not restore the biomechanical integrity of the cornea.

Quote:

"We can see that with some of the early LASIK flap depths of around 140 to 160 microns we are taking between one quarter and one third of the strength of the cornea away. It doesn?t matter at what point you get wound healing ? this tensile strength will never come back,? he said.

The importance of corneal biomechanics in refractive surgery outcomes has become apparent with recent publications.11,12 The corneal stroma consists of lamellae (organized collagen fibers), which run from limbus to limbus. Traditional LASIK, using a mechanical microkeratome, creates a fl ap approximately 160 μm thick, which severs a significant number of collagen fibers compared to PRK. The loss of lamellar integrity following LASIK results in compromised corneal biomechanical integrity due to minimal biomechanical loading distributed throughout the flap. Hence, there is no contribution from the flap to the biomechanical stability of the cornea.1 Cohesive tensile strength studies demonstrate that Bowman?s layer is the strongest structural component of the cornea followed by the anterior third of the corneal stroma.1,13 In fact, the peripheral anterior third of the corneal stroma is stronger than the paracentral and central anterior third.12 These findings are supported by morphologic studies that demonstrate more collagen lamellar interweaving and collagen lamellae orientations that were transverse to the anterior surface of the cornea.14-16 These studies suggest that a thin, uniform flap would leave more of the strong anterior stroma untouched, which should provide greater corneal biomechanical strength than the thicker traditional LASIK flap that severs more of these strong anterior fibers.

Quote:

In addition, we speculate that flaps made deep to this level (traditional LASIK), in the weaker posterior cornea where the lamellae lie more parallel and less compact, create weaker corneal biomechanics.

You may choose to have LASIK surgery on both eyes at the same time or to have surgery on one eye at a time. Although the convenience of having surgery on both eyes on the same day is attractive, this practice is riskier than having two separate surgeries.

If you decide to have one eye done at a time, you and your doctor will decide how long to wait before having surgery on the other eye. If both eyes are treated at the same time or before one eye has a chance to fully heal, you and your doctor do not have the advantage of being able to see how the first eye responds to surgery before the second eye is treated.

Another disadvantage to having surgery on both eyes at the same time is that the vision in both eyes may be blurred after surgery until the initial healing process is over, rather than being able to rely on clear vision in at least one eye at all times.

RESULTS: After PRK, keratocyte density in the anterior stroma decreased by 40%, 42%, 45%, and 47% at six months, two years, three years, and five years, respectively (P < .001). At five years, keratocyte density decreased by 20% to 24% in the posterior stroma (P < .05). After LASIK, keratocyte density in the stromal flap decreased by 22% at six months (P < .02) and 37% at five years (P < .001). Keratocyte density in the anterior retroablation zone decreased by 18% (P < .001) at one year and 42% (P < .001) at five years. At five years, keratocyte density decreased by 19% to 22% (P < .05) in the posterior stroma.

CONCLUSIONS: Keratocyte density decreases for at least five years in the anterior stroma after PRK and in the stromal flap and the retroablation zone after LASIK.

_________________Broken Eyes

"The price good men pay for indifference to public affairs is to be ruled by evil men." Plato

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